New storage method for donor hearts reduces risk of failure after transplant
Researchers in Leuven have demonstrated a new method for storing donor hearts that reduces the risk of heart failure after transplantation and could address the severe shortage of donor organs.
If donor hearts are stored in a specially designed machine instead of on ice, as is traditionally done, there is a lower risk of failure and the hearts can be better preserved. The findings come from a new international study, led by UZ Leuven university hospital, recently published in the scientific journal The Lancet.
Cold storage with ice is the current standard for preserving donor hearts. However, after the heart has been removed from the body for more than three hours, the risk of severe heart failure increases. As soon as a donor heart is available for transplantation, surgery needs to be carried out quickly. Complex transplants, however, take longer, and are becoming more common.
Positive results
Other organs, such as kidneys, are stored in a perfusion machine, in which cooled preservation solution is pumped through the organ. Machine perfusion has also been tested in livers and researchers have found positive results.
A heart muscle cell is complex and is much more sensitive to oxygen deprivation than liver, kidney or lung cells, meaning it takes longer to introduce new techniques.
Now, however, scientists led by UZ Leuven have preserved donor hearts using a similar device. The machine can maintain a constant ideal temperature and administer additional nutrients. The heart can be preserved for up to 24 hours, and continues to function well afterwards.
The study took place from 2019 to 2023 in eight European countries. A total of 204 patients were randomly divided into two groups: half received a heart preserved using the new method, while the other half received a heart stored on ice.
"After almost 60 years, we finally have a better storage method for the heart awaiting transplantation"
All donor hearts preserved with the perfusion machine were suitable for transplantation. In the first 24 hours after surgery, the risk of heart failure fell by 61 per cent. The risk of major complications was 44 per cent lower in the group that received a heart from the new device.
“After almost 60 years, we finally have a better storage method for the heart awaiting transplantation,” said Filip Rega of UZ Leuven, cardiac surgeon and principal investigator of the study. “The method significantly improves the recovery of patients after transplantation by causing less damage to the heart than when stored on ice.”
The technique could expand the pool of available donor hearts, of which there is a severe shortage.
The criteria for accepting organs are based on the traditional preservation method and some potential organs do not qualify, for example because of the donor’s age or an underlying condition. Those criteria could now be adjusted and the number of available donor hearts increased.
#FlandersNewsService | Surgeons with a perfusion storage machine © PHOTO XVIVO PERFUSION
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